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News
Older adults on hemodialysis are often prescribed medications that do more harm than good, and a new study says a structured deprescribing protocol is both safe and well-received by patients. The IMPROVED study found gabapentinoids were the top target for deprescribing, with no serious adverse events reported. The catch? Most nephrologists say fitting it into their daily workflow is still a major hurdle.
Older adults on hemodialysis take an average of nearly 16 medications a day, and many of those — like gabapentinoids and muscle relaxants — carry more risk than benefit. A new feasibility study called IMPROVED, published in Kidney360, tested a structured deprescribing protocol for patients aged 55+ on hemodialysis and found it was safe, acceptable to patients, and produced no serious adverse drug withdrawal events.
The three-step process involved medication review, delivering deprescribing recommendations, and shared decision-making with patients. Of 41 eligible patients approached, 17 agreed to try deprescribing — mostly targeting gabapentinoids used for neuropathic pain. While 41% experienced some symptom recurrence, no one ended up in the ER or hospital as a result.
Key Takeaways:
Why it matters: With dialysis patients managing a large number of medications daily, deprescribing offers a real opportunity to reduce harm — but scaling it will require better workflow integration, clearer patient communication, and dedicated pharmacy support.
